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A 65-year-old female has a history of hypertension, hyperlipidemia, and episodic migraines. Her blood pressure is chronically elevated and she is non-compliant with her antihypertensive therapy. She had a cerebral infarct 5 years ago, from which she recovered fully, with no residual deficits. She is asking for a prescription of an injectable sumatriptan for her severe migraines. What is the most appropriate response to her request?

Select Your Answer:

1. Prescribe injectable sumatriptan as per her request 2. Suggest an oral triptan instead of an injectable triptan 3. Recommend the use of a daily preventable medication to reduce her need for abortive therapy 4. Advise her that her headaches will eventually resolve without any intervention

Teaching Points

Triptans and other agonists should not be prescribed in patients with uncontrolled hypertension, cardiovascular disease, or cerebrovascular disease.

Prescribing triptans or agonists in this patient may lead to stroke or heart attack.

She should be prescribed a daily preventive medication to reduce the severity and frequency of her migraine headaches.

Triptans exert their effects by vasoconstriction and should not be given to patients with vascular ischemic syndromes.